地塞米松玻璃体内植入剂治疗Vogt-Koyanagi-Harada综合征的效果  

Efficacy of intravitreal dexamethasone implant in the treatment of Vogt-Koyanagi-Harada syndrome

作　　者：沈志新 余其智 杜诚 Shen Zhixin;Yu Qizhi;Du Cheng(Department of Ophthalmology,Jiaxing Traditional Chinese Medical Scientific Affiliated Hospital of Zhejiang Chinese Medical University Hospital,Jiaxing 314001,China;Jiaxing Key Laboratory of Ocular Table Corneal Disease Research,Jiaxing 314001,China)

机构地区：[1]浙江中医药大学附属嘉兴中医院眼科,嘉兴314001 [2]嘉兴市眼表角膜病研究重点实验室,嘉兴314001

出　　处：《中华眼外伤职业眼病杂志》2023年第10期795-800,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评估地塞米松玻璃体内植入剂(傲迪适)治疗Vogt-Koyanagi-Harada(VKH)综合征的效果。方法回顾性病例系列研究。纳入嘉兴中医院2020年3月至2021年2月Vogt-Koyanagi-Harada综合征的7例(14眼)中重症2例、轻中症5例。重症者均口服泼尼松8周,并于第3 d时联合地塞米松玻璃体内植入剂玻璃体内注射。轻中症患者不口服泼尼松片,余均同重症患者治疗方法。随访12个月,观察患眼注射前后最佳矫正视力(BCVA)、眼压、黄斑中心区视网膜厚度(CMT)、眼部不良反应及全身并发症的发生情况。结果本研究所有患眼BCVA均于治疗2周后提升5行以上,玻璃体浑浊转为轻度,眼底后极部渗出性视网膜脱离基本消失,CMT重症者较治疗前降低,轻中症者较治疗前降低,后极部视网膜水肿基本消退;治疗2个月后,患者BCVA恢复正常、眼底后极部视网膜结构恢复正常;治疗10个月后所有患者病情均无反复,且均无严重并发症发生。结论轻中症VKH单纯使用地塞米松玻璃体内植入剂注射治疗,重症者联合全身糖皮质激素口服治疗均取得了成功的初步尝试。Objective To evaluate the efficacy of intravitreal dexamethasone implant(Ozurdex)in the treatment of Vogt-Koyanagi-Harada(VKH)syndrome.Methods This was a retrospective case series study.Seven cases of VKH syndrome in Jiaxing Traditional Chinese Medicine Hospital from Mar.2020 to Feb.2021 were included.There were 2 cases of severe disease and 5 cases of mild to medium disease.In severe cases,prednisone was taken orally for 8 weeks and injected with intravitreal dexamethasone implant at the 3rd day.Patients with mild to medium disease were treated with the same treatment as severe patients except for those who did not take prednisone tablets orally.The follow-up period was 12 months and the changes of best corrected visual acuity(BCVA),intraocular pressure and central macular thickness(CMT)before and after injection,adverse eye reactions and systemic complications were observed.Results BCVA increased by more than 5 lines,vitreous turbidity turned mild,posterior polar exudation retinal detachment basically disappeared,CMT of both severe and mild to medium patients were lower than that before treatment in all affected eyes from this study.After 2 months of treatment,BCVA returned to normal,and the posterior polar retinal structure recovered.After 10 months of treatment,there was no recurrence in all cases,and there were no serious complications.Conclusion The mild and moderate VKH are simply treated by intravitreal dexamethasone,and the oral treatment of systemic corticosteroids in severe cases has made a successful preliminary attempt.

关 键 词：地塞米松 玻璃体内植入剂 综合征 Vogt-Koyanagi-Harada 注射 玻璃体内 

分 类 号：R773[医药卫生—眼科]